The Secret to a Healthier City: Sharing Data

To be effective and strategic in their decision-making, city leaders striving to build a culture of health need diverse, usable, high-quality data sources that are integrated, timely, relevant and geographically precise.

“In Cincinnati, partnerships, shared expertise, and data integration have helped us as we seek answers to complex problems. Indeed, I have come to learn that seeking consultation from a housing expert may prove just as valuable to my patients and families as would a consultation from a cardiologist or gastroenterologist.” – Dr. Andrew Beck, Cincinnati Children’s Hospital

This post was co-authored by Peter Eckart, Alison Rein and Nick Wallace.

Data can be a powerful tool for understanding issues, making smarter decisions, and improving results – and city leaders can help build a culture of health by supporting the collection, access and use of data to establish programs and policies that improve both economic and population health through education, transportation, housing and other critical issues.

However, collecting and using data from multiple sources and sectors is challenging, and is often hampered by the organizational, cultural, and budgetary silos that pervade municipal government. Data collected by local hospitals, the department of health, and the Mayor’s office are not often shared with one another due to real or perceived legal restrictions, turf issues, and lack of capacity. While opening access to data and allowing it to be integrated with other data types and sources is not yet the norm for city leadership, a few cities have modeled the extraordinary benefits of such efforts.

Community Health Peer Learning Program (CHP) grantee, Cincinnati Children’s Hospital Medical Center, has embarked on an effort to identify “hot spots” where the incidence of disease, such as asthma, is especially high. Between 2009 and 2011, children from low-income areas in Hamilton County were 88 times more likely to be admitted into the hospital for emergency asthma treatment than children from high-income areas. Pinpointing the disparities at the neighborhood level has allowed the hospital to partner with the Cincinnati Health Department to more effectively link at-risk children to home inspectors that can help to identify the existence of potential health hazards. The hospital has also built a medical-legal partnership with the Legal Aid Society of Greater Cincinnati to pursue legal advocacy when dealing with noncompliant landlords. Thus, home hazards like lead, pests, and mold have been mitigated, new roofs have been installed on several buildings and new heating and air-conditioning units have been put in. The community also recently received a $29 million grant from HUD to accelerate the rehab in one at-risk neighborhood.

Dr. Andrew Beck, a pediatrician at Cincinnati Children’s, notes, “Hospitals and social service agencies, public and private, seek to promote health and wellness among those they serve. We seek the same goal, but we generally work separately. In Cincinnati, partnerships, shared expertise, and data integration have helped us as we seek answers to complex problems. Indeed, I have come to learn that seeking consultation from a housing expert may prove just as valuable to my patients and families as would a consultation from a cardiologist or gastroenterologist.”

The example from Cincinnati makes it clear that leaders should be intentional about nurturing and encouraging a culture of data sharing across various organizations and sectors. Building these sometimes difficult but necessary data sharing relationships is core to All In: Data for Community Health, a nationwide learning collaborative that aims to help communities build capacity to address the social determinants of health through multi-sector data sharing. The two founding partners of All In, Data Across Sectors for Health (DASH) and the CHP Program recently presented together on NLC’s Culture of Health Web Forum Series. The BUILD Health Challenge and the Colorado Health Foundation’s Connecting Communities and Care have also become partners in All In, which now collectively represents 50 local data sharing projects across the country.

Here are just a few lessons from the All In learning collaboration that may be useful to cities in the early stages of multi-sector data sharing:

Relationships are critical to moving data integration forward: Sharing data is as much about relationships as it is about technology. Everything that we know about making collaborations work – developing a shared understanding of the problem, willingness to work together, building trust, communicating clearly, creating a shared governance – applies even more to data sharing partnerships.

Effective data sharing is a considerable time investment, and requires laser-like focus on the problem statement: It can take several years to get people to the table, build meaningful relationships, learn how other sectors operate, and develop data sharing agreements. Creating an environment for data sharing that supports and sustains this commitment requires gaining buy-in from partners and key community stakeholders to ensure their dedication to the driving purpose and continued participation over the long haul.

Data can be used both to identify and characterize city challenges, and to effectively target limited city resources: City officials often know they have an issue, but data are critical for determining scale and scope, and for understanding root causes. Similarly, once these challenges are better understood, interventions are often based on the knowledge that integrated data permits better targeting of city services (e.g., lead poisoning abatement, falls prevention, city planning), and more efficient use of scarce resources.

While there is no roadmap for this complex work of building multi-sector partnerships to share data, there are several resources available to city leaders who want to learn from others who have been down a similar path.

Thirty cities nationwide are engaged in the National Neighborhood Indicators Partnership (NNIP), a peer network of open data intermediaries. The NNIP shares lessons from local partners to help strengthen capacity for data-driven decision-making.

Github is an open source hub that contains many technical tools for sharing data that can be adapted by others.

What Works Cities is a national initiative designed to accelerate cities’ use of data and evidence to improve results for their residents.

DASH’s Environmental Scan provides a nationwide snapshot of the current state of multi-sector data sharing initiatives for community health. AcademyHealth will soon release a scan of the national program offices supporting these initiatives.

The All In Data for Community Health learning collaborative regularly shares news and resources to help guide and advance the field of multi-sector data sharing for health. Sign up for the monthly newsletter to get updates.

City leaders play a critical role in building lasting multi-sector partnerships that help unleash the full potential of local data. As city leaders innovate and experiment, it’s critical that they share their challenges and successes. If we are agile and open to learning from others, we can maximize data infrastructure investments to achieve greater collective impact.